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Meta-Analysis
. 2024 Jan 19:14:04004.
doi: 10.7189/jogh.14.04004.

Syphilis epidemic among men who have sex with men: A global systematic review and meta-analysis of prevalence, incidence, and associated factors

Yang Zheng  1   2 , Kangli Ye  1 , Meike Ying  1 , Ying He  1 , Qi Yu  3 , Lei Lan  4 , Wenzhi Xu  5   6
Affiliations
Meta-Analysis

Syphilis epidemic among men who have sex with men: A global systematic review and meta-analysis of prevalence, incidence, and associated factors

Yang Zheng et al. J Glob Health. .

Abstract

Background: We aimed to estimate the prevalence and incidence of syphilis at global, regional and national levels for human immunodeficiency virus (HIV)-positive and HIV-negative men who have sex with men (MSM) and explore the association between demographic and social behavioural factors and syphilis infection.

Methods: We searched PubMed, Embase, and the Cochrane Library from 1 January 2012 to 31 December 2022 for studies of reported crude syphilis prevalence or incidence in MSM or with sufficient data to calculate prevalence or incidence rate in MSM.

Results: We included 376 articles reporting on 409 records from 62 countries to calculate syphilis prevalence and incidence in MSM. The pooled prevalence of syphilis in MSM was 10.4%, with substantial differences between countries and regions. Syphilis prevalence was substantially higher in HIV-positive than in HIV-negative MSM. The pooled incidence of syphilis in MSM was 76.4 per 1000 person-years. Older age, lower education, nitrite or recreational drug use, group sex, and multiple sexual partners were identified as risk factors for syphilis infection.

Conclusions: A disproportionate geographic pattern of syphilis infection in MSM and significant threats of syphilis infection were revealed. The 'hidden risk' in specific regions and the inadequately elucidated drivers of high-risk behaviours, need to be fully acknowledged and addressed.

Registration: PROSPERO: CRD42023422218.

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Conflict of interest statement

Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests.

Figures

Figure 1
Figure 1
Flowchart of studies selection process.
Figure 2
Figure 2
Estimated syphilis prevalence in MSM by country. Panel A. Syphilis prevalence in overall MSM population. Panel B. Syphilis prevalence in HIV-positive MSM subpopulation. Panel C. Syphilis prevalence in HIV-negative MSM subpopulation
Figure 3
Figure 3
Estimated syphilis prevalence by subgroup in MSM. Points and lines represent pooled prevalence estimates and 95% confidence intervals (CIs).
See this image and copyright information in PMC

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